Fact Sheet

New Study Shows Critical Role for Primary Care
Specialists

Most Often the Source of Preventive Care

Americans made an estimated 890 million doctor visits in 2002, and a
majority of those visits were to primary care specialists, according to the
latest annual report from CDC’s National Ambulatory Medical Care Survey,
which looks at the medical care provided in physicians’ offices.

Primary care specialists (such as general practitioners, family
physicians, internists, pediatricians, obstetricians and gynecologists) play
important roles in the health care system: serving as personal care
physicians, providing preventive and diagnostic services, counseling and
educating patients on appropriate health behaviors, managing and
coordinating patient care, and facilitating access to specialty and follow
up care. During 2002, six out of every 10 doctor visits (an estimated 560
million visits) were to primary care specialists.

The survey, which collects information on visits to non-federally
employed physicians providing office-based care, included a supplemental
sample of primary care specialist physicians in 2002 to spotlight the role
of this group and provide comparisons between primary care and other
specialists. In 2002, about 20 percent of all doctor visits were to surgical
specialists (such as orthopedic surgeons and urologists) and 17 percent were
to medical specialists (such as allergists and dermatologists). While these
medical and surgical specialists can (and do) provide primary care and
preventive services, nine out of 10 preventive care visits are to primary
care specialists. Preventive care includes services such as general medical
exams, prenatal exams or pap tests. Primary care specialists are also more
likely to conduct diagnostic and screening services than surgical or medical
specialists.

About a fifth of primary care specialists made one or more home visits
during a typical week of practice (compared to about 6 percent of medical
and surgical specialists) and during a typical week they averaged about 12
visits. Primary care specialists also reported more telephone contacts with
patients.

In addition to its 2002 spotlight on primary care, the new report
profiles visits to all office-based doctors. In looking at visits to all
doctors, the most frequent patient diagnoses in 2002 were:

Hypertension (high blood pressure)

Common cold

Sore throat

Diabetes

Arthritis and joint disorders.

At about two-thirds of doctor visits, patients were ordered, prescribed
or administered one or more medications, totaling 1.3 billion drugs in 2002.

The utilization of drugs has increased by 25 percent over the past
decade, driven primarily by an increase in those receiving multiple drugs.
The most frequent drugs prescribed during doctor visits in 2002 were in
three classes: NSAIDS (non-steroidal anti-inflammatory drugs such as
ibuprofen and similar drugs), antidepressants, and antihistamines. From 1995
to 2002, NSAIDS use increased by 10 percent, antihistamine use by 35
percent, and antidepressants were up by 48 percent. The use of
antidepressant drugs in children increased by 124 percent from 1995 to 2002.

The survey found other changes in medical care in the past 10 years. From
1992 to 2002, the percent of visits by patients with private insurance
increased by 80 percent and the percent of visits where there was no
third-party payer declined by 77 percent. During the same period, the visit
rate for persons 45 years of age and over increased by 14 percent. In 2002,
about 75 percent of physicians used electronic billing records, but only
about 17 percent have electronic medical records.

The report, "National Ambulatory Medical Care Survey: 2002 Survey," and
more information about the survey conducted by CDC’s National Center for
Health Statistics can be found at
http://www.cdc.gov/nchs/. The survey is part of the National Health Care
Survey, which also covers hospitals, outpatient and emergency departments,
ambulatory surgery centers, nursing homes, hospices, and home health care.
The survey provides an opportunity to examine health care across a range of
settings and to monitor patterns and shifts in the way health care services
are provided and used.